Big news in the menopause world: The Food and Drug Administration has just approved the drug elinzanetant as a non-hormonal treatment for hot flashes. The medication, which will be marketed under the name Lynkuet, is now the third non-hormonal drug to treat moderate to severe hot flashes in menopausal women.
There’s been a lot of attention on treatments for symptoms of menopause lately. In July, FDA Commissioner Marty Makary, MD, hosted a panel to discuss removing the black box warning on vaginal estrogen, which is used to treat vaginal dryness in menopause. Dr. Makary also vowed during that panel to “set the record straight” about hormone therapy in menopause.
But hormone therapy isn’t for everyone, and some people are nervous to try this type of treatment due to a flawed study—which has since been disproved—that linked hormone therapy with cancer (more on that in a sec). That’s opened the door for more forms of non-hormonal therapy for women in menopause, including Lynkuet.
So what is Lynkuet, and how does it stack up against other treatment options for symptoms of menopause? Here’s what ob-gyns who treat women in menopause want you to know.
What is Lynkuet?
Lynkeut is a once-daily pill that treats moderate to severe hot flashes in menopausal women. It’s made by Bayer, the same company that makes Aleve, Claritin, and a slew of other popular medications.
The way the medication works can get a little technical. On a macro level, it blocks the chemicals in your brain that cause hot flashes and night sweats, Lauren Streicher, MD, a clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine, tells SELF.
As estrogen drops in the body during menopause, the nerves in your brain’s hypothalamus—which helps regulate your body temperature—start to produce a lot of chemicals called neurokinins, Dr. Streicher explains. Lynkeut specifically targets neurokinin 1 and neurokinin 3 receptors to help lower the odds that these neurokinins will dock on your cells, ultimately helping to reduce hot flashes.
Lynkeut comes with the risk of a few side effects, including:
- headache
- fatigue
- dizziness
- feeling drowsy or sleepy
- stomach pain
- rash
- diarrhea
- muscle spasms
Lynkuet is effective at reducing hot flashes.
Lynkuet has been through several clinical trials to get approval. Results from a phase 3 clinical trial published in September of 628 postmenopausal women found that those who took the medication for 12 weeks had a more than 73% reduction in their vasomotor symptoms, which include hot flashes.
By comparison, people who took a placebo had a 47% reduction in hot flashes.
The participants who took Lynkuet also said they had less sleep issues and a better quality of life over the course of a year compared to when they weren’t on the medication.
How does Lynkuet differ from other forms of nonhormonal treatments for menopause?
As mentioned above, there are currently three non-hormonal medications approved by the FDA to treat hot flashes in menopausal women: Veozah, Brisdelle, and now Lynkuet.
Brisdelle is an antidepressant, and it’s not commonly recommended by ob-gyns for hot flashes, Mary Jane Minkin, MD, a clinical professor of obstetrics and gynecology and reproductive sciences at Yale School of Medicine and founder of Madame Ovary, tells SELF. “Basically, all of the selective serotonin reuptake inhibitors (SSRIs) have some hot flash help as part of the drug.”
Dr. Streicher also says Brisdelle is “not nearly as effective” at preventing hot flashes compared to Veozah and Lynkuet.
Of these three medications, Veozah and Lynkuet are the most similar. Both target neurokinin receptors, but Veozah is a neurokinin 3 inhibitor, while Lynkuet targets neurokinin 1 and neurokinin 3, Dr. Streicher explains.
“Both are excellent for hot flashes,” Dr. Minkin says. While both medications can help with sleep issues, Lynkuet is actually indicated to help with sleep, Dr. Streicher points out.
It’s easy to assume Lynkuet is better, given that it targets two receptors instead of one, but that there have been no head-to-head trials on these to see which one comes out on top.
When should you consider hormone therapy?
Doctors stress that hormone therapy is still considered the best treatment option for symptoms of menopause. “Provided someone can take hormones, hormone therapy is still the most effective treatment for hot flashes,” G. Thomas Ruiz, MD, lead ob-gyn at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, tells SELF. “Hormone therapy and estrogen in particular is without a doubt, head and shoulders better than any other substance out there.”
These non-hormonal treatments also “do nothing for dry vaginas, dry skin, bladder issues, achiness, etc,” Dr. Minkin says. “In general, my go-to remedy for someone who is dealing with many menopausal issues is hormone therapy—and it's likely to be cheaper too,” she says. Dr. Streicher agrees. “Estrogen hormone therapy is still the first line treatment,” she says.
So why aren’t more women using hormone therapy? It likely goes back to that rocky history of hormone therapy for menopause that we mentioned before. In 2003, preliminary results from the Women’s Health Initiative (WHI) clinical trial linked hormone therapy used to treat symptoms of menopause to a higher risk of developing several serious health conditions, including stroke and heart disease. As a result, the trial was halted. But research since then has found flaws in those findings, and plenty of studies since have found that hormone therapy in menopause has a lot of benefits for women, including better bone and heart health.
In fact, the original WHI trial investigators came out with a follow-up analysis in 2024 that concluded that hormone therapy is a safe and effective treatment for women in menopause. But the idea that hormone therapy is dangerous has stuck around.
“People seem to think that they should try something non-hormonal first,” Dr. Streicher says. “That’s not true.” (However, non-hormonal options are often best for people with certain types of breast cancer and who have a history of deep vein thrombosis, Dr. Ruiz says.)
Overall, “hormone therapy is recommended when menopausal symptoms are disruptive and affect a woman’s quality of life,” Sherry Ross, MD, ob-gyn and women’s health expert at Providence Saint John’s Health Center in Santa Monica, CA, tells SELF.
Which treatment option is best?
When it comes to deciding on a treatment option for symptoms of menopause, Dr. Streicher recommends thinking about your goals. “If the only thing you’re concerned about is your hot flashes, non-hormonal medications can help,” she says. “But if you’re concerned about your bone health, heart, and all of the other things that estrogen can do, then hormone therapy may be better.”
Ultimately, Dr. Streicher says that non-hormonal medications are a better fit for women who can’t take estrogen (like the cancer patients we just mentioned) or those who prefer not to take hormones.
Dr. Minkin points out that some health insurance policies won’t cover medications like Lynkuet and Veozah, which means you can end up shelling out hundreds of dollars for a one-month supply. “So if you would like to try them, check with your health care provider about getting a coupon.”
Ultimately, Dr. Ruiz says that the new non-hormonal medications are promising. “But all that being said, they’re still not as effective as estrogen,” he adds.
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